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RRPA Pharmacology III > Hyp-Pit (Exam 1) > Flashcards

Hyp-Pit (Exam 1) Flashcards

1
Q

GH deficiency is treated with?

A

Somatotropin

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2
Q

Laron syndrome is treated with?

A

Mecasermin (IGF-1)

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3
Q

Treatment for acromegaly?

A

Octreotide (IR-ER), Lanreotide (ER), Cabergoline, Pegvisomant

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4
Q

Treatment for neurogenic diabetes insipidus?

A

Desmopressin

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5
Q

Treatment for nephrogenic diabetes insipidus?

A

Fluids, thiazides, and NSAIDs

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6
Q

Treatment for SAIDH?

A

Restrict free H2O, NaCl, Tolvaptan, Canivaptan

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7
Q

Thy hypothalamus releases ______ to stimulate GH release from the ant. pituitary.

A

GHRF

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8
Q

What hormone released by the hypothalamus causes negative feedback for GH release?

A

Somatostatin

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9
Q

GH is metabolized to what in the liver?

A

IGF-1

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10
Q

IGF-1 preforms positive feedback where?

A

On somatostatin release from the hypothalamus.

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11
Q

IGF-1 preforms negative feedback where?

A

GH release from ant. pituitary.

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12
Q

GH preforms negative feedback where?

A

GHRH release from hypothalamus.

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13
Q

Function of both GH and IGF-1 is?

A

Growth of peripheral tissue.

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14
Q

Growth hormone is also called?

A

Somatotropin

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15
Q

List some things that increase release of GH.

A

GHRH, exercise, hypoglycemia, dopamine, arginine, ghrelin.

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16
Q

List some things that decrease GH release.

A

somatostatin, dopamine agonists.

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17
Q

What is the route of administration for somatotropin?

A

SC

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18
Q

How long after injection do somatotropin levels peak? How long is it active after injection?

A

Peak 2-4 hours

Active levels persist 36 hours

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19
Q

What is the treatment for a child with GH deficiency?

A

SC injection of somatotropin daily at bedtime.

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20
Q

List some of the brand names for somatotropin injections.

A

Humatrope, serostim, genotropin, nutropin, norditripin.

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21
Q

What is more common, GH deficiency or GH insensitive deficiency?

A

GH deficiency

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22
Q

GH insensitive deficiency is also known as?

A

Laron syndrome

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23
Q

Treatment for Laron syndrome?

A

Recombinant IGF-1 (mecasermin)

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24
Q

What side effect of mecasermin is concerning?

What can you do to minimize this side effect?

A

Hypoglycemia

Increase carb intake prior to SC injection.

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25
Uses of GH in adults?
Pituitary tumor, turner's syndrome, prader willi syndrome, chronic renal insufficiency, wasting or cachexia in AIDS patients, short bowel syndrome.
26
T/F? Off label use of GH is illegal.
True
27
Adverse reactions to GH?
Insulin resistance, idiopathic intracranial hypertension, pancreatitis, gynecomastia, nevus growth.
28
GH misuse in athletes can cause?
Acromegaly, arthropathy, extremity enlargement, visceromegaly.
29
Somatostatin is also known as?
SST, SRIH (somatotropin releaseing inhibiting hormone)
30
What medication are somatostatin analogs?
Octreotide and Lanreotide
31
Routes of administration for somatostatin analogs?
Octreotide - SQ every 6-12 hours Lanreotide - SQ every 4 weeks Octreotide LAR - IM every 4 weeks
32
Preferred treatment for excess of growth hormone?
Surgical resection when possible.
33
When surgical resection is not possible, what is the preferred therapy for excess growth hormone?
Lanreotide is preferred after response seen to SC octreotide
34
Second line treatment for excess GH?
Dopamine agonists - Cabergoline OR GH receptor antagonist - Pegvisomant
35
What are non-pituitary uses of somatostatin analogs?
Constriction of vascular smooth muscle for treatment of esophageal varices and GI hemorrhage
36
Adverse reactions to somatostatin analogs?
Hyperglycemia, abd cramps, loose stools, sinus brady, and conduction disturbances
37
Prolactin is released from?
Ant pituitary
38
Prolactin release is inhibited by?
Dopamine
39
Main stimulus for prolactin release?
Suckling - causes 10-100 fold increase within 30 minutes
40
Prolactin release is under inhibitory control by hypothalamic dopamine at ___ receptors.
D2
41
Prolactin stimulates?
Milk production
42
Prolactin inhibits?
Gonadotropin (FSH/LH) release and ovarian response to those hormones. Results in lack of ovulation during breastfeeding
43
Treatment for hypoprolactinemia?
No commercially available preperation
44
Treatment for hyperprolactinemia?
Dopamine agonists
45
Preferred dopamine agonist for hyperprolactinemia?
Cabergoline - More selective for D2 receptor and more effective in reducing prolactin secretion.
46
Second line dopamine agonist for hyperprolactinemia?
Bromocriptine
47
ADH is also known as?
Vasopressin
48
ADH is released from?
Post pituitary
49
The main stimulus for release of ADH is?
Rising blood osmolarity
50
ADH release is inhibited by?
Ethanol
51
Renal actions of ADH are mediated by?
V2 receptors (GCPRs)
52
Mechanism of action of ADH to decrease water excretion?
Increase rate of insertion of aquaporins into luminal membrane
53
What are non-renal V2 actions?
Increased release of coagulation factor VIII and von Willebrand's factor
54
Treatment of choice for neurogenic diabetes insipidus?
Desmopressin
55
Routes of administration for desmopressin?
SC, IV, Nasally, Orally
56
Nephrogenic diabetes insipidus can be congenital due to aquaporin mutations, or caused by drugs. Name 2 drugs that can cause nephrogenic diabetes insipidus.
Lithium | Demeclocycline
57
Treatment of nephrogenic diabetes insipidus?
Fluids Thiazide diuretics NSAIDs (indomethacin)
58
Diabetes insipidus is post. pituitary _____ (hypo/hyperfunction). SAIDH is post. pituitary ______(hypo/hyperfunction).
hypofunction | hyperfunction
59
What drug classes are most commonly implicated in SAIDH?
SSRIs, haldoperidol, TCAs Sunfonylureas (chlorporpamide) Vinca alkaloids (chemo) Methylenedioxymethamphetamine (MDMA)
60
Treatment of SAIDH?
Restriction of free water intake NaCl administration Demeclocyline or lithium
61
SAIDH causes hyponatremia. How is this treated?
V2 receptor antagonists - Tolvaptan (oral), Conivaptan (IV)
62
Rapid correction of hyponatremia should be avoided to reduce risk of?
Cerebellar pontine myelinolysis
63
Vasopressin is used for treatment of?
Severe septic shock

RRPA Pharmacology III (9 decks)

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